Principles of renal transplantation in the dog: A review

The practically relevant body of knowledge available on renal transplantation in the dog is reviewed. A review of the history of renal transplantation is followed by a detailed description of the immunological fundamentals of transplantation, with especial regard to the structures directing rejection, the significance of D-LA-typing and the MLR test serving for their determination, and the possible methods of nonspecific and specific immunosuppression. The most important criteria of recipient and donor selection are presented, together with the main aspects and medicinal protocol of prednisolone-azathioprine and prednisolone-cyclosporin A immunosuppression within the framework of preparation for the surgical intervention. Among the surgical aspects of renal transplantation, first the recommended anaesthetic techniques are outlined, then the three stages of the surgical procedure, i.e. donor nephrectomy, renal perfusion and renal grafting, are described in detail. The last chapter of the article presents the physical, laboratory and instrumental diagnostic methods of rejection diagnosis, with special regard to their practical importance and different roles played in signalling the rejection.